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South Ogden Pediatric Dental P.c.
Pediatric Dentist in Washington Terrace, Utah
NPI 1104834191

South Ogden Pediatric Dental P.c. is a Pediatric Dentist based in Washington Terrace, UT and is specialized in Pediatric Dentistry. South Ogden Pediatric Dental P.c. practices in Washington Terrace, UT. The NPI Number for South Ogden Pediatric Dental P.c. is 1104834191 and holds a License No. 5118697-9923 (Utah).

The current practice location address for South Ogden Pediatric Dental P.c. is 5275 S. Adams Ave.,, Washington Terrace, UT and can be reached out via phone at 801-475-6433 and via fax at 801-334-8411.

Location: 5275 S. Adams Ave.,, Washington Terrace, UT, 84405
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1104834191
Provider Name
South Ogden Pediatric Dental P.c.
Credential
Provider Entity Type
Organization
Address
5275 S. Adams Ave.,, Washington Terrace, UT, 84405
Phone Number
801-475-6433
Fax Number
801-334-8411
Provider Enumeration Date
08/04/2006
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
518155919002 05 UT
institution
Provider Business Practice Location Address Details
Address
5275 S. Adams Ave.,
City
Washington Terrace
State
Utah
Zip
84405
Phone Number
801-475-6433
Fax Number
801-334-8411
person
Provider Business Mailing Address Details
Address
5275 S. Adams Ave.,
City
Washington Terrace
State
Utah
Zip
84405
Phone Number
801-475-6433
Fax Number
801-334-8411
person
Provider's Taxonomy Details 1
Type
Dental Providers
Classification
Dentist
Speciality
Pediatric Dentistry
Taxonomy
1223P0221X
License No.
5118697-9923 (Utah)
Definition
An age-defined specialty that provides both primary and comprehensive preventive and therapeutic oral health care for infants and children through adolescence, including those with special health care needs.
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